PURPOSE: To investigate the clinical manifestations and diagnoses of optic disc swelling. METHODS: The medical records of 49 patients who experienced optic disc swelling between March 2008 and June 2009 were retrospectively reviewed. The characteristics of non-arteritic anterior ischemic optic neuropathy (NA-AION) and optic neuritis (ON), which showed optic disc swelling most commonly, were compared. RESULTS: NA-AION was the most common disorder (34.7%) that presented with optic disc swelling. ON was identified in 15 patients (30.6%). Seven out of 49 patients (14.3%) had intracranially associated diseases, such as papilledema and compressive optic neuropathy. Pseudopapilledema was noted in four patients (8.2%). Other diseases (e.g., papillophlebitis, neuroretinitis, and diabetic papillopathy) were seen in six patients (12.2%). Ocular pain was observed more commonly in patients with ON (p = 0.001). Patients with ON expected a better visual prognosis than patients with NA-AION (0.12 +/- 0.32 vs. 0.49 +/- 0.35, p = 0.001). CONCLUSIONS: NA-AION and ON should be considered in the differential diagnosis when patients with optic disc swelling present to the neuro-ophthalmology clinic. Detailed history taking and supportive examinations, such as visual field, color-vision and imaging tests, should also be performed as indicated. Regular follow-up of such exams is necessary for the differential diagnosis of these diseases.
Adult ; Female ; Humans ; Male ; Middle Aged ; Optic Nerve Diseases/complications/etiology ; Optic Neuritis/complications/physiopathology ; Optic Neuropathy, Ischemic/complications/physiopathology ; Papilledema/*etiology ; Retrospective Studies ; Visual Fields

We report a very rare case of odontogenic orbital cellulitis causing blindness by severe tension orbit. A 41-yr old male patient had visited the hospital due to severe periorbital swelling and nasal stuffiness while he was treated for a periodontal abscess. He was diagnosed with odontogenic sinusitis and orbital cellulitis, and treated with antibiotics. The symptoms were aggravated and emergency sinus drainage was performed. On the next day, a sudden decrease in vision occurred with findings of ischemic optic neuropathy and central retinal artery occlusion. Deformation of the eyeball posterior pole into a cone shape was found from the orbital CT. A high-dose steroid was administered immediately resulting in improvements of periorbital swelling, but the patient's vision had not recovered. Odontogenic orbital cellulitis is relatively rare, but can cause blindness via rapidly progressing tension orbit. Therefore even the simplest of dental problems requires careful attention.
Adult ; Anti-Bacterial Agents/adverse effects/therapeutic use ; Blindness/*diagnosis/etiology ; Drainage ; Fluorescein Angiography ; Humans ; Male ; Optic Neuropathy, Ischemic/complications ; Orbit/*physiopathology ; Orbital Cellulitis/*diagnosis ; Retinal Artery Occlusion/complications ; Sinusitis/diagnosis/drug therapy ; Tomography, X-Ray Computed ; Tooth Root